Ancient Rome: Health and Medicine

A Roman Bronze Medical Box

Ancient Rome, like Greece and Egypt before it, was very concerned with the subject of medicine and health. The Romans preferred to seek prevention methods instead of cures for each disease, however, and poured their time into public health facilities, rather than medical theories like the Ancient Greeks. Each discovery may not have necessarily been within the field of pure medicine, but the citizenry’s lack of hygiene was a major culprit of diseases, meaning any type of public health remedies were guaranteed to impact society.

The Romans gathered a lot of information from the Ancient Greeks. Both first came into contact around 500 BC, and by 146 BC part of Greece had become a division of the Roman Empire. By 27 BC, Greece and neighbouring lands around the Mediterranean who spoke Greek came under the Romans control.

Their ideas were a reflection of Ancient Greek theories but not direct copies, as they found them impractical. The Romans appeared to be more concerned with direct improvements of the quality of life in the empire.

Greek geographer Strabo claimed “The Greeks are famous for their cities and in this they aimed at beauty. The Romans excelled in those things which the Greeks took little interest in such as the building of roads, aqueducts and sewers."

This may not have been the most accurate statement, but the Romans did seem to be a more practical nation than their Greek neighbours. Cicero, the famous writer, noted:

"The Greeks held the geometer in the highest honour, and, to them, no-one came before mathematicians. But we Romans have established as the limit of this art, its usefulness in measuring and reckoning. The Romans have always shown more wisdom than the Greeks in all their inventions, or else improved what they took over from them, such things at least as they thought worthy of serious attention."

During the Empire’s early years, there were no real practising medical professionals. Instead, the head of each household was assumed to have enough knowledge of herbal cures and medicine to treat illnesses and injuries at home.

Port du Gard

As Pliny, another Roman writer, observed:

"Unwashed wool supplies very many remedies… it is applied… with honey to old sores. Wounds it heals if dipped in wine or vinegar… yolks of eggs… are taken for dysentery with the ash of their shells, poppy juice and wine. It is recommended to bathe the eyes with a decoction of the liver and to apply the marrow to those that are painful or swollen."

Once the Roman Empire had expanded into Greek territory, many of its doctors relocated to Italy and Rome. Some, as prisoners of war, could be bought by rich Romans to work in their household, making them valuable. Some of these medics eventually bought their own freedom and were able to set up practices in Rome, though their success in their new home did breed mistrust among their countrymen.

Pliny voiced exactly these misgivings:

“I pass over many famous physicians men like Cassius, Calpetanus, Arruntius and Rubrius. 250,000 sesterces were their annual incomes from the emperors. There is no doubt that all these physicians in their hunt for popularity by means of some new idea, did not hesitate to buy it with our lives. Medicine changes everyday, and we are swept along on the puffs of the clever brains of the Greeks… as if thousands of people do not live without physicians - though not, of course, without medicine.”

At the same time, however, many Greek physicians were directly supported by the Emperor, while the most well known were in demand from the Roman public. Another of Pliny’s accounts describes how when one of these celebrity doctors, Thessalus, was walking around in public, more crowds were drawn to him than to any of the famous actors or chariot riders that graced Rome.

The Romans strongly believed that a healthy mind would equal a healthy body, and if you were physically fit you were much more likely to fight an illness. Because of this, many Romans would rather spend money keeping fit than going to a doctor.

The Greek philosopher Celsus made this recommendation:

“A person should put aside some part of the day for the care of his body. He should always make sure that he gets enough exercise especially before a meal.”

The Romans desire to improve the public health system came from their belief that illnesses were caused naturally, and bad health could be triggered by unclean water and sewage. This was not just for wealthy people’s benefit, but slaves as well - their workers were required to be in good health. So the Romans were essentially the first civilisation to introduce public health services for all classes, not just the rich.

Ostia Toilets

Cities, villas and forts in Rome were built in healthy places, as the Romans knew the difference between a good place to build and less suitable places.

Marcus Varro, a scholar and writer, describes this process:

"When building a house or farm special care should be taken to place it at the foot of a wooded hill where it is exposed to health-giving winds. Care should be taken where there are swamps in the neighbourhood, because certain tiny creatures which cannot be seen by the eyes breed there. These float through the air and enter the body by the mouth and nose and cause serious disease."

Columella, another Roman, describes the agricultural perspective:

"There should be no marshes near buildings, for marshes give off poisonous vapours during the hot period of the summer. At this time, they give birth to animals with mischief-making stings which fly at us in thick swarms."

The health of Rome’s legions was naturally considered very important as without them, the Roman Empire would fall. A lot of emphasis was placed on legionnaires having access to clean water and keeping fit , while officers were discouraged from camping near swamps so they would not drink the fetid water. They were also moved around regularly as it was feared they may pick up the existing diseases if they stayed in the same place for too long.

The Romans valued clean water very much, writes the architect Vitruvius:

“We must take great care in searching for springs and, in selecting them, keeping in mind the health of the people.”

Cities, towns and forts were all built near fresh springs. Though when these grew, water needed to be brought in from further away. Naturally, as the population grew, the need for clean water did too. As the empire’s capital city, Rome had to have a water supply that would make a good impression. This was designed by Julius Frontinus who was appointed the Water Commissioner in 97 AD. An estimated 1,000 million litres of water a day was carried into Rome.

Personal hygiene was also a constant issue in the Romans lifestyle, which placed an important factor onto the public baths.

There were also toilets in Roman houses and on streets - something which was also a part of other civilisations but were designed to show wealth. By 315 AD Rome was said to have had 144 public toilets all flushed clean by running water. All forts had toilets, and to complement them an effective drainage system was needed. According to the Roman writer Pliny, many Romans believed that Rome sewers were the city’s biggest achievement.

Seven rivers were designed to flow through the city’s sewers and flush any sewage out. Military hospitals also had a focus on hygiene importance, as the Romans believed injured soldiers would recover quicker in a clean environment.